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Individual

EVELYN M FALCON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
6625 MIAMI LAKES DR E, SUITE 383, MIAMI LAKES, FL 33014-2708
(305) 498-1306
(305) 726-0093
Mailing address
14602 ROSEWOOD RD, MIAMI LAKES, FL 33014-2658
(305) 498-1306
(305) 726-0093

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0005134
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000925647A
PEACHSTATE
GA
05
000925647A
GA
05
002243700
FL
01
10034878
AMERIGROUP
GA
01
326070
WELLCARE
GA
Enumeration date
11/08/2006
Last updated
04/09/2014
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